SBIRT in Primary Care: Why it Matters for Texas Health Steps Providers

SBIRT in Primary Care: Why Does it Matter for Texas Health Steps Providers?

“SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons with substance use disorders, as well as those who are at risk of developing these disorders.”

Substance Abuse and Mental Health Services Administration (SAMHSA, n.d.)

Screening, Brief Intervention and Referral to Treatment (SBIRT) is an evidence-based approach that helps primary care providers identify risky alcohol or substance use early (screening), respond with a focused conversation (brief intervention) and connect patients to treatment when needed (referral to treatment). SBIRT supports routine, preventive care by making substance use screening part of regular visits rather than waiting until problems become more serious. 

For Texas Health Steps providers, SBIRT can be especially valuable because early identification and brief intervention may help protect health, support healthy development and refer young patients to appropriate services. Texas Medicaid provides separate reimbursement for SBIRT for eligible patients age 10 years and older when program requirements are met.

Consider the following three patients and determine which of them may be a candidate for SBIRT in your primary care office.

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Hector
15 years

Case Example 1: Hector, age 15. 

Hector is in your office for his 15-year Texas Health Steps preventive medical checkup. During routine screening, Hector acknowledges occasional alcohol use at parties and recent marijuana use with friends. Based on the screening results, Hector is at mild to moderate risk for alcohol or substance misuse. 

Gaby
16 years

Case Example 2: Gaby, age 16. 

Gaby is in your office for her 16-year Texas Health Steps preventive medical checkup. She has lost weight since her last checkup and seems disinterested in school and her previous activities, both of which may be signs of depression. She tells you she doesn’t spend much time at home because she is tired of her parents complaining that her friends are a bad influence on her. 

Keisha
18 years

Case Example 3: Keisha, age 18. 

Keisha has brought her son Elias in for his 6-month Texas Health Steps preventive medical checkup. As you examine Elias, Keisha notes that she is not sleeping well and is under great stress managing her school, work and parenting responsibilities. She asks you to prescribe a medication to help her cope with the stress. 

Select one answer and use the Submit button to check your response.

Which patient is a candidate for SBIRT:

Hector

This answer is partially correct.

This patient is a candidate for SBIRT based on the potential for risky alcohol or substance use. However, the other patients also may benefit from SBIRT.

Gaby

This answer is partially correct.

This patient is a candidate for SBIRT based on the potential for risky alcohol or substance use. However, the other patients also may benefit from SBIRT.

Keisha

This answer is partially correct.

This patient is a candidate for SBIRT based on the potential for risky alcohol or substance use. However, the other patients also may benefit from SBIRT.

All of the above

This answer is correct.

All three patients are candidates for SBIRT based on their potential for risky alcohol or substance use. 

Submit

SBIRT gives providers a practical way to address substance use in routine clinical care. By learning more about SBIRT and incorporating it into routine practice, Texas Health Steps providers can strengthen prevention efforts, support early intervention and help young patients access timely treatment when needed.

Learn more about SBIRT by taking the quick course Implementing Universal SBIRT in Primary Care: Tools and Resources for your Practice.